Quarterly Performance Report September 2009 Health... · September 2009, 606 people had been...

1ACT Public Health Services Quarterly Performance Report September Quarter 2009

Your health — our priority

ACT PUBLIC HEALTH SERVICESQuarterly Performance Report

September 2009

ACT Public Health Services Quarterly Performance Report September Quarter 20092

Our Public Hospitals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Elective surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Emergency Department services . . . . . . . . . . . . . . . . . . . . . . 10

Patient Safety and Quality Unit . . . . . . . . . . . . . . . . . . . . . . . 12

Capital Region Cancer Services. . . . . . . . . . . . . . . . . . . . . . . 14

Community Health Services . . . . . . . . . . . . . . . . . . . . . . . . . 15

Responsiveness to Older Canberrans . . . . . . . . . . . . . . . . . . 16

Births at ACT public hospitals. . . . . . . . . . . . . . . . . . . . . . . . 16

Mental Health Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Selected activity statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Contents


Minister’s ForewordWelcome to the ACT Public Health Services quarterly performance report for the first quarter of 2009–10.

The first quarter of 2009–10 was particularly challenging for our public health services. Our emergency departments reported the highest levels of activity on record in July and August 2009,

and our hospitals re-adjusted elective surgery schedules for the year to ensure that we would have had the capacity to effectively manage swine flu had it turned into a more virulent strain during the winter months.

As a result, elective surgery throughput over the first three months of 2009–10 was lower than for the same period last year. However, full year targets are expected to be achieved based on anticipated levels of demand for services.

Items of note for the first quarter of 2009–2010:

• Demandforinpatientservicescontinuestogrow.Whilepreliminary results show a drop in ‘cost weighted’ activity, our hospitals reported a 1.4 percent increase in the number of people treated over the first three months of 2009–10 compared with the same period in 2008-09, and a 4.5 percent increase in non same-day bed numbers.

• Workisunderwaytoprovideuptoanadditional24bedsforour public hospital system during 2009–10, on top of the 206 extra beds we have added to the system over the last seven years.

• Thisincreasedinvestmentinextrabedsisworkingtoreducebed occupancy rates. Preliminary results for the first quarter of 2009–10 show a bed occupancy rate of 88 percent (against the target 87%), a decrease of three percent on the previous year.

• Ouroutpatientoccasionsofserviceforthefirstquarter2009–10 were 10% above the total reported for 2008–09 and 22% above 2007–08.

• Thenumberofelectivesurgeryoperationsduringthefirstthree months of 2009–10 (2,453), was 10 percent down on the previous year’s result due to planned reductions in elective care as part of ACT Health’s management strategy for the H1N1 outbreakandincreaseddemandforrespiratorymedicineservices this year.


• Thiswasalsoreflectedinourintensivecareservices(ICU),with The Canberra Hospital reporting the highest ever level of ICU bed days on record during the first quarter of 2009–10 — with 1,344 bed days, up 17 percent from the 1,144 reported for the same period last year.

• Despitethisreducedelectivesurgeryactivity,thenumberofextended wait patients continues to improve. At the end of September 2009, 606 people had been waiting for elective surgery longer than one year, a 42% drop on the 1085 reported at the same time three years ago.

• Emergencydepartmentwaitingtimesforthemosturgentcategories (category one and two patients) continue to meet or exceed national targets. This is despite an 15% growth in more urgent category 1 and 2 admissions compared with the first quarter of 2008-09. In addition, there has been more considerable improvements in waiting times for category three, four and five patients, despite the highest level of demand for emergency department care on record.

• Theaveragewaitingtimeforpublicdentalhealthservices— at 12 months in the September quarter 2009 — is up on last year’s result, but right on target (and below the 14 months reported for the same quarter of 2007–08).

• Ourchildhoodimmunisationratesremainabovethenational target of 92% reporting an outcome of 94% in the first quarter of 2009–10.

• NotwithstandingtheincreasedpressuresonthesystemaspartoftheH1N1outbreak,thereremainsomeareasthatrequire attention including:

• Waitingtimesforlessurgent(category3and4)emergencydepartment patients remain below target. However there has been significant improvements for both category 3 and 4 patients this year compared to the same period in 2008-09, with category 3 timeliness reporting an 11% improvement, and category 4 timeliness improving by 13%.

• Accessblock(thedelayintransferfromtheemergencydepartment to a hospital ward) is around 23%, up 1% on last year. While this is due to the considerable increase in demand for emergency department services, the rate is well above our target of 25%.

• Waitingtimeforbreastscreeningservicesishigherthanthe national target. However, demand for breast screen


services is at an all time high — up 28% in the first quarter of 2009–10 compared with the same quarter last year

• Inlightoftheabove,thegovernmentisfundingarangeofinitiatives including adding beds to the system, introducing new ways to provide services, and expanding services to improve access to services.

This report demonstrates our continued commitment to provide our clinicians with the resources necessary to meet increasing demands for services. The public will also begin to see more evidence of our $1 billion investment in our public health infrastructure as the first of the plans that have been developed over recent months begin to be turned into steel and concrete. The new buildings and services that will progressively come on line over the next decade will ensure that we are able to respond more effectively to the health needs of our community well into the future.

This report contains a range of data on ACT Health services.

The data is correct as at the time of publication. However, some changes to published data may be apparent in subsequent reports due to the availability of more up to date data.

The results and trends noted in the report should be considered in terms of national trends, changes in the level of demand, targets (where appropriate) and recent initiatives aimed at improving performance.

Large amounts of health service information, particularly hospital data, is categorised in accordance with the relative resource usage of the particular service (this is referred to as cost weighted activity).

The allocation of particular codes (or cost weights) in relation to the typeofservicesprovidedcantakesometimetocomplete,especiallyin relation to those patients who require a range of services during a single hospital stay.

Cost weights are updated regularly to reflect changes in costs and practice.Careneedstobetakenincomparingdatainthisreportwith data presented in previous reports in previous years that may be presented using earlier versions of the National Public Hospital Cost Weights.

Cost weights in this report are provided using Round 11 National Public Cost Weights.

For further information about cost-weights, visit the Commonwealth Department of Health and Ageing website: http://health.gov.au/internet/wcms/publishing.nsf/Content/Casemix-1


OUR PUBLIC HOSPITALSBusier hospitals, more beds

Over the previous two years our public hospitals responded to unprecedented increases in demand for inpatient (admitted patient) services. Preliminary results for the first quarter of 2009–10 are yet to show a continuation of this growth, however, despite a drop in cost weighted activity, the actual number of patients treated at our hospitals increased by 1.4 percent, and the number of non same-day bed days rose by 4.5 percent over the first quarter of this year compared with the same period last year.

The apparent drop in cost weighted activity (which weights patient activity based on the level of resources required to provide care) is due to a change in the type of services provided in the first quarter of 2009–10 compared with last year and the level of medical record coding.

In July and August this year our hospitals reported an increase in medical conditions (such as flu and respiratory diagnoses) with smaller cost weights, and a drop in higher cost weight activity, such as orthopaedic surgery as part of the planned reduction in elective surgery to meet increased demand for medical services. This will return to a more normal mix of cases as the year progresses.

In addition, the results for the first quarter of any year contains a large proportion of ‘uncoded records’. At the end of a patient’s stay,herorhismedicalrecordischeckedbyaspecialistcoder,who allocates certain codes to a patient’s medical record based on clinician notes. These codes determine the cost weight allocated to each patient stay. However, this process is time consuming. As such, the September figures for 2009–10 contain a large proportion of uncoded records, and as such, should be considered with care. This situation is less of an issue for later reports as the proportion of uncoded records will comprise a smaller and smaller percentage of the total records.

Notwithstanding this, there has been a consistent increase in the level of activity at our public hospitals over recent years. As a result, the Government has responded to the increased demand for health services in the ACT with considerable additional investments in health services over the last eight years (left).The budget for 2009–10 ($973.2 million) is 106 percent above the $472 million provided for health services in 2001–02.

This funding has met the cost of additional specialist clinical staff and supplies, and funded initiatives aimed at better systems and processes to improve access to services and the quality of those services.

82 1

37

90 1

58

73 8

63

ACT Public Hospitals Cost weighted admitted patient separations

(Round 11 National cost weights, AR-DRG Version 5.1)

*preliminaryPrevious Years vs Year-to-date Septermeber

ACT Health ACT Health Expenditure by Year

$ million

512 56

3 636 69

7 751 83

9 939 97

4

2002

-03

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

2008

-09

2009

-10*

ACT Public Hospitals Available beds by year

ACT Public Hospitals Bed occupancy rate*

(overnight adult medical and surgical beds)

2006-07 2007-08 2008-09 2009-10*Year to September

*Year to September

Source: ACT Public Hospitals

ACT Public Hospitals Non-admitted (outpatient)

occasions of service*

2007-08 2008-09 2009-10

The Canberra Hospital, Calvary Public Hospital, Aged Care and Rehabilitation Service and Capital Region Cancer Service

*estimates onlySource: ACT Health Annual Report

Source: Australian Hospital Statistics, AIHW, 2002-03 to 2006-07 publications, with ACT Health estimate for 2008-09 and 2009-10

20 8

16 22 7

28 24 7

32

24 1

89

92% 91% 91%88%

ACT Public Hospitals Non-same day bed days

2006-07 2007-08 2008-09 2009-10All outputs, including general hospital, agedcare and rehabilitation, cancer services and

mental health service inpatient services

2006-07 2007-08 2008-09 2009-10*

683

679 71

4

785

851 87

6 900

200

3-0

4

200

4-0

5

2005

-06

2006

-07

2007

-08

2008

-09*

200

9-10

*

56 6

60

57 5

03

58 0

95

60 6

76

82 1

37

90 1

58

73 8

63





$ million

512 56

3 636 69

7 751 83

9 939 97

4

2002

-03

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

2008

-09

2009

-10*





*Year to September




2007-08 2008-09 2009-10




20 8

16 22 7

28 24 7

32

24 1

89

92% 91% 91%88%




2006-07 2007-08 2008-09 2009-10*

683

679 71

4

785

851 87

6 900

200

3-0

4

200

4-0

5

2005

-06

2006

-07

2007

-08

2008

-09*

200

9-10

*

56 6

60

57 5

03

58 0

95

60 6

76

82 1

37

90 1

58

73 8

63





$ million

512 56

3 636 69

7 751 83

9 939 97

4

2002

-03

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

2008

-09

2009

-10*





*Year to September




2007-08 2008-09 2009-10




20 8

16 22 7

28 24 7

32

24 1

89

92% 91% 91%88%




2006-07 2007-08 2008-09 2009-10*

683

679 71

4

785

851 87

6 900

200

3-0

4

200

4-0

5

2005

-06

2006

-07

2007

-08

2008

-09*

200

9-10

*

56 6

60

57 5

03

58 0

95

60 6

76


These additional funds have enabled the Government to add up to an additional 230 beds within public hospital system, including the beds coming on line during 2009–10. These additional beds will provide up to 900 available hospital beds by the end of 2009–10, up considerably from the 670 available in 2001–02.

The specific funding provided in the 2009–10 budget included: • $2.5milliontowardincreasedcriticalcarecapacity,providing

up to two additional critical care beds.• $3milliontowardincreasedacutecarecapacityincluding

a 16 bed Surgical Assessment and Planning Unit.• $2millionforadditionalelectivesurgerycapacity• $2.6millioneachyear(inafullyear)toprovideaMental

HealthAssessmentUnit,plannedtoworklikeitsmedicalandsurgicalcounterpartsbyprovidingquickeraccesstospecialist care for people arriving at emergency departments.

The beds added to our public hospitals have enabled us to meet increasingdemandforservices,andincreasedcapacitytotakesomepressure off services. This continued investment in additional capacityisworking,withareductioninthebedoccupancyoverthe first three months of 2009–10. The 88 percent result for the first quarter is marginally above the Government’s full year target for 2009–10 of 87 percent. The Government’s long term target is to further reduce bed occupancy levels to around 85 percent, which is considered the best level for best patient outcomes and to achieve maximum efficiency.

The Government’s bed strategy has been complemented by a new focus on medical, nursing and allied health recruitment to ensure thatwehavethetrainedworkforcenecessarytocontinuetoopennew beds.

Data published by the Productivity Commission in their recent report on government statistics demonstrates our success in this area, with our hospitals having higher levels of doctors and nurses per 100, 000 residents than the Australian average.

The Medical Appointments and Training Unit, Nursing and Midwifery Office and the Office of the Allied Health Adviser all continue to focus on the development of new ways to attract qualified staff to the ACT.

The increase in demand for services has not only been felt within our inpatient services. Over the first quarter 2009–10, outpatient services (those services provided at hospitals which do not require admission) have increased by 10 percent compared with the same period in 2008 09, and 22 percent above the total provided two years ago.

The growth in the provision of outpatient services is anticipated to continue over the medium term as more services are provided in an outpatient setting (where appropriate).

82 1

37

90 1

58

73 8

63





$ million

512 56

3 636 69

7 751 83

9 939 97

4

2002

-03

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

2008

-09

2009

-10*





*Year to September




2007-08 2008-09 2009-10




20 8

16 22 7

28 24 7

32

24 1

89

92% 91% 91%88%




2006-07 2007-08 2008-09 2009-10*

683

679 71

4

785

851 87

6 900

200

3-0

4

200

4-0

5

2005

-06

2006

-07

2007

-08

2008

-09*

200

9-10

*

56 6

60

57 5

03

58 0

95

60 6

76

82 1

37

90 1

58

73 8

63





$ million

512 56

3 636 69

7 751 83

9 939 97

4

2002

-03

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

2008

-09

2009

-10*





*Year to September




2007-08 2008-09 2009-10




20 8

16 22 7

28 24 7

32

24 1

89

92% 91% 91%88%




2006-07 2007-08 2008-09 2009-10*

683

679 71

4

785

851 87

6 900

200

3-0

4

200

4-0

5

2005

-06

2006

-07

2007

-08

2008

-09*

200

9-10

*

56 6

60

57 5

03

58 0

95

60 6

76

82 1

37

90 1

58

73 8

63





$ million

512 56

3 636 69

7 751 83

9 939 97

4

2002

-03

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

2008

-09

2009

-10*





*Year to September




2007-08 2008-09 2009-10




20 8

16 22 7

28 24 7

32

24 1

89

92% 91% 91%88%




2006-07 2007-08 2008-09 2009-10*

683

679 71

4

785

851 87

6 900

200

3-0

4

200

4-0

5

2005

-06

2006

-07

2007

-08

2008

-09*

200

9-10

*

56 6

60

57 5

03

58 0

95

60 6

76


ACTPublicHospitalsareontracktomeetthisyear’stargetforelective surgery operations, despite reporting lower levels of activity in the first quarter of 2009–10 compared with the same period last year.

A total of 2,453 elective surgery operations were performed over the first three months of 2009–10. The decrease in the number of surgeries performed this year compared with the same period lastyearcanbeattributedtotheH1N1outbreakandtheneedto reduce activity to provide bed capacity in the result of an epidemic. The reduction in elective surgery activity was planned by our hospitals as a means to meet any upsurge in demand for public hospital services during this period.

Nine percent of elective surgery cases were postponed during the first three months of 2009–10. The main reasons for postponement were due to the need to treat more urgent patients, and the increased medical activity surrounding the H1N1 virus. Despite this, the result for the first three months of this financial year was an improvement on the previous year — and well below the 13% reported in 2006–07.

The Government continues to focus on ensuring that the most urgent elective surgery cases are seen on time, while also addressing those less-urgent patients with extended waiting times. While more needs to be done, the available evidence showsthatthisapproachisworking.

At 30 September 2009, there were 606 people with waiting times of greater than 12 months, which is 14 percent fewer than the 707 people waiting longer than one year on 30 September 2008 and 42 percent below the 1,055 reported just three years ago.

The drop in the number of people waiting longer than one year for surgery is directly related to the effectiveness of the Government’s ‘long wait’ elective surgery strategy over recent years.

While this strategy is continuing, the Government will always focus on more urgent patients. This can be seen in the reduction in long wait patients accessing elective surgery during the first three months of 2009–10. As our hospitals focussed on more urgent cases due to the planned reduction in elective

ELECTIVE SURGERY More people accessing surgery, fewer people waiting too long for care and fewer postponements

2510

2425 27

18

2453

16

14

15

14

165

195

168 17

7

79

91 99 99

753 81

2

945

811

ACT Elective Surgery Waiting List Number of people removed from the list for surgery*

*Year to SeptemberSource: Elective surgery data set

ACT Elective Surgery Waiting List Proportion of patients who have

their elective surgery postponed*

2006-07 2007-08 2008-09 2009-10

*Year to JuneSource: Elective surgery data set

2006-07 2007-08 2008-09 2009-10



Source: Elective surgery data set



2006-07 2007-08 2008-09 2009-10




2006-07 2007-08 2008-09 2009-10


2006-07 2007-08 2008-09 2009-10

ACT elective surgery waiting list Number of people waiting longer

than one year for surgery*

Elective Surgery Waiting List Number of long wait patients

receiving surgery

Elective Surgery Waiting List Proportion of Category One patients

who have their elective surgeryon time*

Elective Surgery Waiting List Median wait time for category one patients*

(surgery desirable within 30 days)

Elective Surgery Waiting List Median wait time for category two patients*


Elective Surgery Waiting List Median wait time for category three patients*


13%

8%

10%

9%

1055

885

707

606

97%

94%

92%

97%


surgery in July and August 2009, the number of extended wait patients accessing surgery dropped to 811 in the first quarter of 2009–10, down from the 945 for the same period last year.

While there has been a large decrease in the number of patients waiting longer than one year for surgery over recent years, our public hospitals have been able to ensure that the majority of patients with the most urgent elective surgery needs (mainly cancer and major heart surgery patients) continue to access elective surgery within the standard 30 day timeframe.

Of the 717 people classified as category one patients admitted for surgery in over the first three months of 2009–10, 693 people were admitted within the national standard of 30 days (97%). This is a very good result and a significant improvement on the previous two years.

In addition the median waiting time for the most serious elective surgery cases (category one patients) dropped marginally, from 15 days over the first three months of 2008–09 to 14 days for the same period this financial year (against the standard maximum waiting time of 30 days).

The median waiting times for category two patients who had their surgery during the year-to-September 2009–10 has remained steady at 99 days. This can be attributed to the push to ensure our most urgent (category one) patients are seen in the shortest time possible.

At the same time the median waiting times for category three patients over the first three months of 2009–10 is 177 days and remains well below the desired time of 365 days. The reduction in the median waiting time for category three patients in 2009–10 reflects the considerable effort in increasing access to elective surgery for patients with excessive waiting times in previous years. The Government is directing resources in 2009–10 to provide additional access to category two patients in 2009–10 and future years.

2510

2425 27

18

2453

16

14

15

14

165

195

168 17

7

79

91 99 99

753 81

2

945

811





2006-07 2007-08 2008-09 2009-10


2006-07 2007-08 2008-09 2009-10






2006-07 2007-08 2008-09 2009-10




2006-07 2007-08 2008-09 2009-10


2006-07 2007-08 2008-09 2009-10




receiving surgery









13%

8%

10%

9%

1055

885

707

606

97%

94%

92%

97%

2510

2425 27

18

2453

16

14

15

14

165

195

168 17

7

79

91 99 99

753 81

2

945

811





2006-07 2007-08 2008-09 2009-10


2006-07 2007-08 2008-09 2009-10






2006-07 2007-08 2008-09 2009-10




2006-07 2007-08 2008-09 2009-10


2006-07 2007-08 2008-09 2009-10




receiving surgery









13%

8%

10%

9%

1055

885

707

606

97%

94%

92%

97%


49%

42%

41%

54%

48%

45%

46%

57%

86%

79% 84

%

83%

ACT public hospitals Category one emergency

department presentations seen on time* (Immediately)

100%

100%

100%

100%

2006-07 2007-08*Year to September

2008-09 2009-10

2006-07 2007-08 2008-09 2009-10

2006-07 2007-08 2008-09 2009-10 2006-07 2007-08 2008-09 2009-10 2006-07 2007-08 2008-09 2009-10

*Year to September

*Year to September *Year to September *Year to September

ACT public hospitals Category two emergency department

presentations seen on time* (Within 10 mins)

ACT public hospitals Category three emergency department

presentations seen on time* (within 30 mins)

ACT public hospitals Category four emergency department


ACT Public Hospitals Category five emergency department


82%

74%

67% 76

%

ACT public hospitals have an excellent record in ensuring that all category one emergency department patients are seen on arrival to hospital.

Over the first three months of 2009–10, 84 percent of category two patients were seen on time. Whilst this is a slightly lower than the result recorded for the same period last year, it remains above the national target of 80 percent on time for this group of patients.

This is an excellent result considering the 15 percent increase in the number of category one and two patient presentations compared with the same period in 2008–09. Despite the considerable increase in complex patients our public hospitals still managed to treat patientsinthesecategorieswithinnationalstandardbenchmarks.

In addition this significant increase of more complex patients has not stopped our hospitals reporting improvements in waiting times for category three, four and five patients. The improvements in category three and four patients are particularly pleasing, with our hospitals reporting the best first quarter timeliness results for category three patients in six years and the best category four results for a first quarter in five years.

Notwithstanding this, waiting times for category three and four presentations to the emergency department need further improvement with the proportion of presentations seen on time for these categories to the emergency department is below nationalbenchmarks(of75%ontimeforcategorythreeand70% on time for category four patients)

EMERGENCY DEPARTMENT SERVICESImprovements in waiting times for emergency department care


ACT Health is committed to continuing the improvement in waiting times for emergency department services. During 2009–10, the Government is implementing a range of initiatives to further improve Emergency Department waiting times including:

• Theopeningofa16bedSurgicalAssessmentandPlanningUnitin2009–10toprovidequickertransferofsurgicalpatientsoutoftheemergencydepartment.Thiswillreduceaccessblockasatpresent, surgical patients are the main driver of the higher than targetaccessblockfigures;and

• AWalkinCentretobeopenedinthe2009–10financialyear.TheCentre will be designed to treat clients with less serious conditions to help alleviate the pressures on the Emergency Department.

The proportion of patients who wait longer than eight hours from the start of treatment at an emergency department to transfer to a hospitalbed(referredtoas“accessblock”)increasedslightlyby 1 percent during the first quarter of 2009–10 compared with the same period in 2008–09. This is a direct result of the nine percent increase in emergency department presentations over this period. The ACT currently uses the NSW Health definition for access block.

Inordertofurtherimprove‘accessblock’results,theGovernmentprovided ACT Health with the funding to provide up to a further 24 hospital beds during 2009–10. This will provide our hospital system with the capacity to improve the flow of patients from the emergency department to hospital wards — thus freeing up emergencydepartmentresourcestoprovidequickeraccesstocare.

Accessblockforolderpersonshasincreasedthisquarter.Theresultof33percentofolderpersonsblockedfromadmissiontoaninpatient bed is above the target of 30 percent, also related to the considerable increase in emergency department presentations over the first three months of 2009–10.

Theaccessblockrateformentalhealthclientsincreasedslightlyin2009–10 compared with the same period last year, however it is on parr with the target of 15 percent. These figures should also be assessed with care given the relatively small number of patients in this client group. Notwithstanding this, in the 2009–10 Budget the Government funded the establishment of a Mental Health AssessmentUnitthat(likeitsmedicalcounterpart)willprovidefortimely assessment of mental health clients who present at the emergency department and more rapid transfer to an inpatient environment when needed. This six bed unit will help to reduce access blockandisanothercomponentofthegovernment’s$1billionCapital Asset Development Plan. The Unit is scheduled to commence operations in early 2010.

Continued improvements within emergency department processes have been noted in ambulance off-stretcher times. During 2009–10, 99 percent of all ambulance attendances were transferred from

32%

29%

22% 23

%

12%

16%

14%

15%

ACT Public Hospitals Ambulance Off Stretcher Time*

2007-08 2008-09 2009-10*Year to September

Source: ACT Ambulance Service

ACT Public Hospitals Emergency Department Access Block*

(Mental health clients)


(patients aged over 75 yrs)


(all Patients)

2006-07*Year to September

2007-08 2008-09 2009-10

*Year to September

2006-07 2007-08*Year to September

Source: Emergency department dataset and ward transfer data set

2008-09 2009-10

2006-07 2007-08 2008-09 2009-10

94%

96% 99

%

43%

32%

33%37

%


ambulances to emergency departments within 20 minutes, well abovethebenchmarkrateof90percent.

ACT Health currently reports on three major national patient safety and quality indicators. The targets for each of the indicators are different for each of our hospitals due to the type and nature of services provided at each of the campuses. As a major teaching and referral hospital, The Canberra Hospital manages more complex patients. As such, higher levels of complications can be expected. This quarter features enhanced

Patient safety and qualityOur hospitals continue to meet safety and quality standards

The Canberra Hospital Rate of unplanned hospital admissions within 28 days

Calvary Public Hospital Rate of unplanned hospital admissions within 28 days

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Unplanned Readmits Target

95% CI Upper 95% CI Lower

0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

1.6%

Unplanned Readmits Target 95% CI Upper 95% CI Lower

The Canberra Hospital Unplanned return to operating theatre

within an episode of care

Calvary Hospital Unplanned return to operating theatre


0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

1.6%

Rate Target < 0.7


0.0%

0.1%

0.2%

0.3%

0.4%

0.5%

0.6%

0.7%

0.8%

Rate Target < 0.4695% CI Upper 95% CI Lower

*nb: lower CI=0%

*nb: lower CI=0%

The Canberra Hospital Hospital Acquired Infection Rate

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

0.0%

0.5%

1.0%

1.5%

2.0%

Rate Target 95% CI Upper 95% CI Lower

Calvary Public Hospital Hospital Acquired Infection Rate

0.0%

0.5%

1.0%

1.5%

2.0%



charts with confidence intervals to better describe Patient Safety and Quality activity.

The Australian Council on Healthcare Standards published a revised version of the method for calculating unplanned readmissions commencing on 1 January 2009. This may influence the monthly rate and future results will clarify the longer term effect of these changes.

The role that The Canberra Hospital plays in our health service means that they have to manage a range of very serious and complex emergency and elective surgery procedures. The current rate for return to operating theatre with an episode of care of 0.97% is above the target rate of 0.7%, but this is not significantly different to the rate of peer organisations participating in the Australian Council on Healthcare Standard clinical indicator program for 2009–10. The result is also not statistically significant given all results fall within the 95% confidence intervals. All cases of unplanned return to the operating theatre are reviewed by safety and quality officers and the Clinical Director of Surgery.

As noted above, the different roles of our public hospitals also impact on the rate of hospital acquired infections. Both hospitals rate well compared with similar hospitals across the nation.

Our infection control officers continue to develop and rollout programs and processes to further limit the transfer of infections within hospitals. This includes communication and education for clinicians, patients, general staff and visitors.

The Canberra Hospital Rate of unplanned hospital admissions within 28 days

Calvary Public Hospital Rate of unplanned hospital admissions within 28 days

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Unplanned Readmits Target


0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

1.6%

Unplanned Readmits Target 95% CI Upper 95% CI Lower

The Canberra Hospital Unplanned return to operating theatre


Calvary Hospital Unplanned return to operating theatre


0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

1.6%

Rate Target < 0.7


0.0%

0.1%

0.2%

0.3%

0.4%

0.5%

0.6%

0.7%

0.8%


*nb: lower CI=0%

*nb: lower CI=0%

The Canberra Hospital Hospital Acquired Infection Rate

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

Q1 2

006-

07

Q2 2

006-

07

Q3 2

006-

07

Q4 2

006-

07

Q1 2

007-

08

Q2 2

007-

08

Q3 2

007-

08

Q4 2

007-

08

Q1 2

008-

09

Q2 2

008-

09

Q3 2

008-

09

Q4 2

008-

09

Q1 2

009-

10

0.0%

0.5%

1.0%

1.5%

2.0%

Rate Target 95% CI Upper 95% CI Lower

Calvary Public Hospital Hospital Acquired Infection Rate

0.0%

0.5%

1.0%

1.5%

2.0%



The Capital Region Cancer Service provided care for 1,248 new radiotherapy patients in 2008–09, an increase of 19 percent on the 1,047 people who began radiotherapy services in the previous financial year (2007–08).

By end September 2009 (the first quarter of 2009–10) Radiation Oncology provided treatment services for 567 new radiotherapy patients which is a six per cent increase on the 536 patients who began radiotherapy services in the same period during 2008–09.

Now that the ACT’s third linear accelerator is operating at full capacity, waiting times for radiotherapy services have improved significantly, with 96 percent of all clients receiving care within standard timeframes over the first three months of 2009–10 compared with 78 percent for the same period in 2008–09.

The BreastScreen ACT Program is a population based screening program for well women which is aimed at detecting abnormalities early.

Most women return a ‘normal’ result from their screen however, about one in twenty screens are referred to a specialist clinician for assessment and further investigations if required.

The BreastScreen ACT Program currently has the best small cancer detection rate in the country.

BreastScreen ACT provided more than 12,000 breast screens in 2008–09 and a further 8,151 screens in SE NSW. This growth in levels of service has continued into 2009–10. Over the first quarter of this financial year, BreastScreen ACT has provided services to 3,674 Canberra women, a 28 percent increase (801 screens) on the 2,873 screens provided over the same period in 2008–09.

ACTHealthacknowledgesthattheBreastScreenACTProgramhasexperienced a large increase in the number of women waiting extended periods for screening. This is directly related to the significant improvements in women waiting for assessment (a 27 percent improvement on three years ago). BreastScreen ACT Programs’ clinical priority is on the assessment of women, ensuring detection rates and clinical outcomes are the focus of the Program.

Despite this, waiting times for assessments have improved during the first quarter of 2009-10 compared with last year. However, the unprecedented increase in demand for breast screens has resulted in a continuation of long waiting times to screening.

Capital region cancer serviceContinued increase in demand for radiotherapy services

Capital Region Cancer Service Urgent Radiotherapy patients seen on time*

2006-07 2007-08 2008-09 2009-10

2006-07 2007-08 2008-09 2009-10

2006-07 2007-08 2008-09 2009-10

2006-07 2007-08 2008-09 2009-10

*Year to SeptemberSource: Capital Region Cancer Service




Capital Region Cancer Service Radiotherapy Patients seen within

the standard time frames*

Capital Region Cancer Service Breastscreen - proportion of women

who receive an appointment within 28 days*

Capital Region Cancer Service Breastscreen - proportion of women

who receive an assessment within 28 days*

88%

100%

100%

100%

58% 67

%

85%

70%

91%

83%

78%

96%

92%

87%

26%

26%


The additional funding added to the dental health program’s budget by the government has resulted in a considerable improvement in the mean waiting time for appointments — from the 16 months recorded in the year 2007–08 to just 12 months in the year-to-September 2009–10. While this result is above the 9 months recorded in the first quarter 2008–09 it is on target. This excellent result continues to ensure that ACT residents have access to urgent dental treatment within the set target of 12 months.

Immunisation rates for one year olds continue to exceed the national target of 90%, with 94% recorded for the first quarter of 2009–10.

Alexander Maconochie Centre (adult corrections centre) and Bimbiri (the youth corrections centre) reported that 82 percent of offenders and detainees received their health care assessment plan within 24 hours of detention.

This is a reduction from the 100 percent reported for the same period in 2008–09. The reduction is a result of changed practices which has resulted in many detainees at Bimbiri being held for short periods, therefore not requiring health assessments. Given this, ACT Health is reviewing this indicator, with the view to changing this measure to provide a more accurate picture of performance in this area.

Community health servicesDental wait times down, immunisations up, increasing responsiveness

100%

82%

95%

91%

94%

93%

94%

Dental Services Mean Waiting Times (in months) for persons on the Centralised

Waiting and Recall List*

Dental Services Proportion of urgent patients

seen within standard waiting times*

2007-08 2008-09 2009-10 2006-07 2007-08 2008-09 2009-10

*Year to SeptemberSource: Dental Health Program


Childhood Immunisation* Proportion of one year olds fully immunised

*Year to SeptemberSource: Population Health Division

2005-06 2006-07 2007-08 2008-09

100%

100%

100%

100%

*Year to SeptemberSource: Community Health

Community Health Offenders and detainees in Quamby & BRC with health care assessment

plans within 24 hours of dentention*

2007-08 2008-09 2009-10

16

9

12

100%

82%

95%

91%

94%

93%

94%

Dental Services Mean Waiting Times (in months) for persons on the Centralised

Waiting and Recall List*

Dental Services Proportion of urgent patients

seen within standard waiting times*

2007-08 2008-09 2009-10 2006-07 2007-08 2008-09 2009-10



Childhood Immunisation* Proportion of one year olds fully immunised

*Year to SeptemberSource: Population Health Division

2005-06 2006-07 2007-08 2008-09

100%

100%

100%

100%

*Year to SeptemberSource: Community Health

Community Health Offenders and detainees in Quamby & BRC with health care assessment

plans within 24 hours of dentention*

2007-08 2008-09 2009-10

16

9

12


Our aged care assessment team provided in hospital assessments within an average of 1.5 days during the first three months of 2009–10 which is better than the target of two days.

This level of service minimises delays in accessing out of hospital services for patients who no longer need hospital care.

The average length of stay for acute rehabilitation of 10.1 days for the first three months of 2009 10, is slightly up on the 9.2 days reported for the same period last year. However, the result is consistent with the general reduction in length of stay following the establishment of the sub-acute rehabilitation facility at the Calvary Public Hospital site. The capacity to transfer people to more appropriate sub-acute services has resulted in a drop of more than five days stay on average within the acute service over the figures reported three years ago.

Responsiveness to older Canberrans

Births at ACT public hospitalsBirths stabilise — but still well above the last few years

Based on preliminary data, a total of 965 babies were born at ACT public hospitals over the first three months of 2009-10, a two percent increase on the same period last year. However, an accurate result requiresallmedicalrecordstobefullyprocessed.Asthiscantakesometime,thereportedresultshould be noted as preliminary only at this stage.

Based on the latest available national data (2007–08), ACT public hospitals continue to provide lower levels of caesarean births compared to public hospitals in the rest of the nation, and are considerably below the levels reported in Australian private hospitals.

Aged Care Rehabilitation Service Waiting time for ACAT Assessments

*Year to SeptemberSource: Aged Care and Rehabilitation Service

Aged Care and Rehabilitation Acute Rehabilitation Average

Length of Stay (in days)*

ACT Public Hospitals Births by Year*

2006-07 2007-08 2008-09 2009-10*

* 2009-10 results are preliminary * Year to SeptemberSource: Admitted patient care data

Proportion of births by caesarean section ACT public hospitals, Australian public hospitals

and Australian private hospitals

2004-05 2005-06 2006-07ACT public hospitals Australian Public HospitalsAustralian Private Hospitals


2006-07 2007-08 2008-09 2009-10

0

1

2

3

Q12007-08

Q2 2008-09

Q32008-09

Q42008-09

Q12009-10

Day

s

Target

1.5 1.7 1.43 1.51.67

24.5

%

23.3

%

23.5

%

26.3

%

26.6

%

27.3

%

40.0

%

40.9

%

42.0

%

2007-08

21.5

% 26.9

%

45.4

%

15.6

13.1

9.2

10.1

915

912 94

8

965

Source: Australian Institute of Health and Welfare






2006-07 2007-08 2008-09 2009-10*






2006-07 2007-08 2008-09 2009-10

0

1

2

3

Q12007-08

Q2 2008-09

Q32008-09

Q42008-09

Q12009-10

Day

s

Target

1.5 1.7 1.43 1.51.67

24.5

%

23.3

%

23.5

%

26.3

%

26.6

%

27.3

%

40.0

%

40.9

%

42.0

%

2007-08

21.5

% 26.9

%

45.4

%

15.6

13.1

9.2

10.1

915

912 94

8

965







2006-07 2007-08 2008-09 2009-10*






2006-07 2007-08 2008-09 2009-10

0

1

2

3

Q12007-08

Q2 2008-09

Q32008-09

Q42008-09

Q12009-10

Day

s

Target

1.5 1.7 1.43 1.51.67

24.5

%

23.3

%

23.5

%

26.3

%

26.6

%

27.3

%

40.0

%

40.9

%

42.0

%

2007-08

21.5

% 26.9

%

45.4

%

15.6

13.1

9.2

10.1

915

912 94

8

965



Mental Health ACT has implemented a number of initiatives to reduce the level of clients secluded during an inpatient episode.Theseinitiativesareworkingwiththerateofseclusiondecreasing considerably over the first three months of 2009–10 compared with last year and two years ago. The current result of 5.46 percent is significantly better than the target set at nine percent and shows constant improvement on recent years’ results.

Mental Health ACT continues to report strong results for the proportion of patients discharged from an inpatient service who receive follow-up care within seven days (right). Timely follow-ups can reduce the number of people who need to be readmitted to an inpatient service. The result for the first three months of 2009–10 of 79 percent is better than that reported in 2008–09. This is a particularly good result despite the increase in voluntary short-stay admissions, with this client groupmorelikelytoelecttoreceivefollow-upwiththeirGPor private psychiatrist, rather than from ACT Mental Health services.

ACT Health is committed to its mental health clients. All Mental Health ACT committees include consumer and carer member involvement. This consultation process provides the best possible integrated mental health services for our community.

A total of 59 percent of patients discharged from an inpatient mental health service have completed outcome assessments. The decrease in this result is largely due to restructuring in staff and projects within the mental health team.

Mental health services

77%

79%

70%

12.2

9%

7.46

%

5.45

%

Mental Health ACT Use of seclusion for clients*

2007-08 2008-09 2009-10

2007-08 2008-09 2009-10

2007-08 2008-09 2009-102007-08 2008-09 2009-10

% clients secluded

Percentage of Completed Outcome Assessments

63%

74%

59%

Mental Health ACT Clients followed up within 7 days of

discharge from an inpatient service*

*Year to SeptemberSource: Mental Health ACT

100%

100%

100%

Mental Health ACT Proportion of mental health committees

with consumer and carer representation*


Mental Health ACT Proportion of clients discharged witha completed outcome assessment*



77%

79%

70%

12.2

9%

7.46

%

5.45

%

Mental Health ACT Use of seclusion for clients*

2007-08 2008-09 2009-10

2007-08 2008-09 2009-10

2007-08 2008-09 2009-102007-08 2008-09 2009-10

% clients secluded

Percentage of Completed Outcome Assessments

63%

74%

59%

Mental Health ACT Clients followed up within 7 days of

discharge from an inpatient service*


100%

100%

100%

Mental Health ACT Proportion of mental health committees

with consumer and carer representation*


Mental Health ACT Proportion of clients discharged witha completed outcome assessment*




ACT Health Selected activity statistics

Year to September*% VAR

2008–09 2009–10

ACT Health cost-weighted separations ( Round 11 DRG version 5.1)

Output 1.1 – Acute services 21 748 21 045 –3%

Output 1.2 – Mental Health services 745 610 –18%

Output 1.5 – Cancer services 976 1 216 25%

Output 1.6 – Aged care & rehabiliation services 1 264 1 318 4%

Total cost weighted separations 24 732 24 189 –2%

Inpatient Activity

Day only patient days (total across all outputs) 11 879 12 208 3%

Overnight patient days (total across all outputs) 58 095 60 676 4%

Nursing Home Type Patient Bed-Days (on separation)** 372 1 586 326%

Day of Surgery Admission rate 88% 87% –1%

NSW residents as a proportion of total hospital separations 23% 23% 0%

Emergency surgery as a proportion of total surgery 43% 46% 3%

Allied health services – Provided in ACT public Hospitals 24 969 22 725 –9%

Admissions via Emergency department 6 878 6 508 –5%

Emergency Department Activity

Category 1 (immediate – 2 mins) 131 120 –8%

Category 2 (within 10 mins) 2 133 2 486 17%



Category 5 (within 120 mins) 3 813 3 529 –7%

Emergency Department Presentations 24 998 27 255 9%

Elective Surgery

Additions to the public hospital elective surgery waiting list 3 388 3 170 –6.43%

Numbers of people on the elective surgery waiting list 5 402 5 756 6.55%

Removals from the list for surgery 2 718 2 453 –10%

Removals for other reason for surgery 651 571 –12%

Patients on the list recorded as ‘not ready for care’ 556 568 2%


Year to September*% VAR

2008–09 2009–10

Median waiting time to care by patient urgency category

Category one patients (admission required within 30 days) 15 14 –1 days

Category two patients (admission desirable within 90 days) 98 99 1 days

Category one patients (admission desirable within 365 days) 168 177 9 days

Elective endoscopiesMedian waiting time to care by patient urgency category

Category one patients (admission required within 30 days) 29 27 –2 days

Category two patients (admission desirable within 90 days) 99 125 26 days

Category one patients (admission desirable within 365 days) 291 372 81 days

Breast screens

Total Number of ACT women 2 873 3 674 28%

Participation rate 50–69 56% 53% –3%

Additions to the Cervical Cytology Register 10 391 9 153 –12%

Community Health Allied health services – Number of regional services 5 307 5 754 8%

Community Nursing – Number of Nursing (Domicilliary and clinic based occasions of service)

18 098 20 266 12%

Mental Health – Community Services by Group

Adult 42 539 44 985 6%

Child & Adolescent 9 377 13 576 45%

Older persons 4 494 3 433 –24%

Outpatient Care – Non Admitted Services

ACT public hospitals 68 805 75 547 10%

Cancer services 12 746 14 111 11%

Aged care and rehabilitation services 586 500 –15%

Total outpatient occasions of service 82 137 90 158 10%

* Note: Cost-weighted separations for September year-to-date 2009-10 are preliminary estimates only.


GlossaryEmergency departmentTriage category Patients presenting to an emergency department are seen on the basis of

clinical urgency as determined by trained medical professionals. Patients are classified into one of five categories, and their access to treatment is based on this clinical categorisation

1. Resuscitation – treatment to commence immediately

2. Emergency – treatment to commence within 10 minutes

3. Urgent –within 30 minutes

4. Semi-Urgent – within 60 minutes

5. Non-urgent –within 120 minutes

Waiting times TThe proportion of patients seen at emergency departments within standard waiting times (as set by the Australasian College of Emergency Medicine)

1. Resuscitation – 100% seen on time 2. Emergency – 80% seen within 10 mins 3. Urgent – 75% seen within 30 mins 4. Semi-Urgent – 70% seen within 60 mins 5. Non-urgent – 70% seen within 120 minsAccessblock Theproportionofpatientsadmittedtohospitalviatheemergency

department who wait longer than eight hours from the time that treatment commences to the time that the patient is transferred to a hospital ward.

Elective surgery Urgency category Patients listed for elective surgery at ACT public hospitals are assigned one

of three priority categories based on their surgeon’s opinion about the urgency of the need for surgery in accordance with the definitions in the National Health Data Dictionary:

1. Urgent – admission within 30 days is desirable for a condition that has thepotentialtodeterioratequicklytothepointthatitmaybecomeanemergency

2. Semi-urgent – admission within 90 days is desirable for a condition causingsomepain,dysfunctionordisabilitybutwhichisnotlikelytodeterioratequicklyorbecomeanemergency

3. Non-urgent – admission at some time in the future acceptable for a condition causing minimal or no pain, dysfunction or disability, which is notlikelytodeterioratequicklyandwhichdoesnothavethepotentialtobecome an emergency (ACT Health establishes a 365 day maximum desirable waiting time for category three patients

Median waiting time The waiting time at the fiftieth (50th) percentile for all patients admitted for elective surgery at an ACT public hospital in a given period (and for a given patient urgency category)

Waiting times The proportion of patients admitted for surgery within a given period who are admitted within standard waiting times for their condition.


Removals for surgery The number of people, in a given period, who are removed from the

ACT public hospitals elective surgery waiting list for surgery.

Patients waiting longer The number of patients still on the elective surgery waiting list (and who are thanoneyearfor listedas“readyforsurgery”)whohavebeenwaitinglongerthan365days surgery (at a given census date).

Long wait patients The number of patients on the ACT public hospitals’ waiting lists who have accessing elective had surgery within a given period whose waiting time was longer than the surgery standard waiting time for their condition when admitted for surgery.

Hospitalinitiated Theproportionofelectivesurgerypatientsbookedforsurgeryinagiven Postponements period who have their surgery postponed by the hospital (for reasons such

as substitution for a more urgent patient, no beds available, etc)

Intensive care unit Patient days The total number of days that intensive care unit resources were used to

care for patients (calculated as the total number of patient days reported for Intensive Care Units in the department’s ward transfer file)

Endoscopy Urgency category See entry for elective surgery

Median waiting time See entry for elective surgery

Dental servicesWaiting times (urgent) The proportion of dental health program clients assessed as in need of

emergency services who receive care within 24 hours of a request

Waiting times (general) The average waiting time (in months) that clients of the adult centralised waiting list wait for care from the time of the request of an appointment to the date of the appointment with the dental health program

Radiotherapy Waiting times (urgent) The proportion of new radiotherapy patients who are assessed as in need of

urgent access to treatment who are provided with treatment within 48 hours of a request

Waiting times (general) The proportion of all new radiotherapy patients who are provided with treatment within 28 days of a request

Breast screeningWait time to assessment The proportion of women requiring assessment who wait 28 days or less

from their breast screen appointment to their assessment appointment

Wait time to The proportion of women who wait 28 days or less from their appointment appointment date to the date of their breast screen

Number of screens Number of ACT women who are provided with breast screens within a given period


Participation rate The proportion of women in the ACT in the targeted age group for breast screening (50 to 69 years) who have had a breast screen within the last two years at any given time.

Bed usage Occupancy rate The proportion of available overnight adult medical and surgical beds that

are used on average over a given period

Ambulance services Off-stretcher times The proportion of emergency department presentations who arrive by

ambulance who are transferred from the care of the ACT Ambulance Service to the staff of the emergency department within 20 minutes of arrival at hospital by the Ambulance

Rehabilitation Acute rehabilitation The average length of stay for all patients of the rehabilitation service who length of stay separated from inpatient services at The Canberra Hospital

Aged care assessment In-hospitalwaitingtimesThemeanwaitingtimeinworkingdaysbetweenarequestfor,andthe

provision of, an in-hospital assessment by the Aged Care Assessment Team (ACAT)

Patient safety Unplanned return to The proportion of patients who are readmitted within 28 days to the same Hospital within 28 days hospital in which they were previously a patient, where the readmission was: unexpected for further treatment of the same condition for which the

patient was previously hospitalised unexpected admission for treatment of a condition related to one for

which the patient was previously hospitalised unexpected admission for a complication of the condition for which

the patient was previously hospitalised

Unplanned return to The proportion of patients who are required to return to the operating the operating theatre room for a further procedure related to complication(s) of a previous operation/procedure within a single admission

Hospital acquired blood The incidence of blood stream infections such as staphylococcus aureus stream infection rate (golden staph) acquired within ACT public hospitals, reported as the

number of infections per 1,000 non-same day occupied bed days

Mental health Outcome assessments The proportion of clients separated from a mental health inpatient unit

who have a completed outcome assessment

Use of seclusion The proportion of patients who are separated from a psychiatric inpatient unit who were subject to seclusion during their inpatient episode


Clients seen within The proportion of clients seen at or contacted by an ACT Health seven days post community facility during the seven days post-discharge from the inpatient discharge from hospital service

Consumer and carer The proportion of Mental Health ACT committees upon which consumers representation and carers are represented

Immunisation Childhood The proportion of children at one year of age fully immunised in immunisations accordance with the Australian Childhood Immunisation Register Schedule

Opioid treatment

Clients with The number of opioid treatment scheme clients who have a management plans plan

Inpatient separations (Admitted patients)

Cost weighted The number of separations (completed episodes of care) expressed in cost separations weightedterms.“Costweighting”allocatesaweightforeachhospital

episode based on the average level of resources used for each type of episode (withtheaverageepisodereceivingaweightof“1”).Asexamples,astandarddialysisepisodehasaweightof0.17oftheaverageandakneereplacementhasaweightofabout“5”(orfivetimestheaverage.ACTHealthusednational public hospital cost weights (Round 9) for counting of hospital episodes in 2007–08.

Day only separations The number of admitted patients (inpatients) who are admitted and separated on the same day.

Overnight separations The number of admitted patients who are admitted and separated on different days

NSW separations The proportion of patients separated from ACT public hospitals whose residential address is in NSW

Patient days In accordance with national definitions, the number of days that a patient spends in hospital. All day only (or same-day) patients are counted as spending one full day in hospital (regardless of the time actually spend in hospital). For non same-day patients, the number of days is calculated by subtracting the separation date from the admission date (in full days)

Nursing home type The number of patient days on separation for all patients who have been patient days classified as nursing home type patients.

Emergency surgery as The proportion of patients who have surgery as a result of an emergency a proportion of all against the total number of surgical procedures surgical services

Day of surgery rate The proportion of all elective surgery cases who are admitted to hospital on the same day that they have their surgery.


Births The number of births reported at our public hospitals in a given period

Caesarean births The proportion of all births at public hospitals that are reported as being undertakenascaesareansections.

Mental health Community services The number of community based services provided to each of the three

client groups: Adults Children and adolescents Older people

Community services Allied health The number of allied health occasions of service provided to hospital (in hospitals) inpatients (covering the areas of: Physiotherapy Occupational Therapy SocialWork Psychology Speech Pathology Nutrition

Allied health The number of allied health occasions of service provided to clients in a (community) community setting (including their home or in a clinic) in the following areas: Physiotherapy (home and clinic) Occupational Therapy (home visits) Social Work (home and clinic) Podiatry (clinic) Nutrition (home and clinic)

Community nursing The number of community nurse occasions of service provided to clients of the ACT Health Continuing Care area, including:

Home visits Ambulatory care visits Foot care clinics Continence clinics Wound clinics Stoma clinics

Non-admitted Services (outpatient) Occasions of service The number of occasions of service provided by outpatient clinics at our

public hospitals, reported in terms of organisational responsibilities: Public hospitals Capital region cancer service Aged care and rehabilitation service

A non-admitted (outpatient) occasion of service is an episode of care where a client interacts with one or more health professionals for assessment, consultation and/or treatment, but does not undergo a hospital’s formal admission process

Quarterly Performance Report September 2009 Health... · September 2009, 606 people had been...

Documents

Transcript of Quarterly Performance Report September 2009 Health... · September 2009, 606 people had been...